Autoimmune Hepatitis

1 What is Autoimmune Hepatitis?

Autoimmune hepatitis is a chronic form of live inflammation caused by autoimmune condition in which the immune system attacks liver cells.

If left untreated it may lead to cirrhosis and liver failure.

It is most commonly seen in women in the age group of 15-40 years.

The actual cause of the autoimmune hepatitis is not known.

Genetic and environmental factors are implied in the development of autoimmune condition that lead to this disease.

It is diagnosed by blood tests and liver biopsy.

Treatment of autoimmune hepatitis is with medications that suppress the immune system or by liver transplant

2 Symptoms

Early stages of autoimmune hepatitis may remain asymptomatic, while the symptoms may appear suddenly in the late stages.

The most common symptoms of autoimmune hepatitis are

  • Fatigue
  • Abdominal discomfort
  • Joint pain
  • Itching
  • Jaundice
  • Enlargement of liver
  • Nausea
  • Spider angioma
  • Dark urine
  • Loss of appetite
  • Pale stool

In women it may lead to absence of menstruation.

Ascites and mental confusion are more severe symptoms of the condition.

3 Causes

As the name indicates, autoimmune hepatitis is caused by an autoimmune condition in which the immune system attacks the liver cells. This cause inflammation and damage to the liver cells.

The actual cause for the autoimmune condition is not known. Genetic and environmental factors are implied in the development of autoimmune condition. There are two main forms of autoimmune hepatitis

Type 1 autoimmune hepatitis

This is the most common type of the disease. Most of the people with this disorder have other autoimmune diseases like celiac disease, rheumatoid arthritis, or ulcerative colitis.

Type 2 autoimmune hepatitis

This is more commonly seen among children and young adults. This type is also associated with other types of autoimmune diseases.

A number of factors like

  • gender,
  • certain infections,
  • heredity, autoimmune diseases

increase the risk of autoimmune hepatitis.

Women are more likely to have autoimmune hepatitis when compared to men. Certain infections like

increase risk of autoimmune condition that cause liver damage.

Autoimmune hepatitis is also found to run in families, suggesting a hereditary link.

History of other autoimmune diseases like celiac disease and rheumatoid arthritis also increase the chance of autoimmune hepatitis.

4 Making a Diagnosis

Autoimmune hepatitis is diagnosed by liver biopsy and blood tests.

Blood tests help to distinguish other conditions like viral hepatitis that have similar symptoms. Blood test assesses the specific antibodies for a condition.

It is also used to identify the type of autoimmune hepatitis.

Liver biopsy is the confirmatory diagnosis for this condition. In liver biopsy a small sample of liver tissue is analyzed in the laboratory to determine the degree of damage. 

5 Treatment

Treatment strategies of Autoimmune hepatitis focus on controlling the autoimmune condition that lead to liver inflammation and damage.

Medications are used to slow down the activity of the immune system.

Prednisone and azathioprine are used to suppress the immune system activity. Prednisone have long term side effects like

After a period of treatment, it is kept at the lowest possible dose to control the symptoms.

Liver transplant is suggested if the response is less for conventional treatment, or if there is liver cirrhosis.

In transplant, liver from a healthy donor is used to replace the diseased liver. In some cases, only a part of the liver from the donor is used for transplant.

This part regenerates into new tissues after the transplant in both donor and receiver.

6 Prevention

There is no standard preventive measures for autoimmune hepatitis.

Knowing the risk factors for the condition may help in detecting and treating the disease early. 

7 Alternative and Homeopathic Remedies

A few alternative and homeopathic remedies are used for Autoimmune hepatitis.

Natural remedies are used to control inflammation and to prevent the progression of the disease.

  • Milk thistle,
  • apple cider vinegar,
  • turmeric

are considered to be effective in this regard.

Milk thistle is used to protect liver from damage and to reduce inflammation.

Turmeric and apple cider vinegar also help in reducing inflammation and liver damage. 

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with Autoimmune hepatitis.

Corticosteroid medications have many side effects which make treatment of this condition challenging for both healthcare personnel and the patient.

Sharing experiences about the treatment help in understanding and coping with the condition.

Being a part of the support group help in understanding and sharing information about the disease and the treatment strategies. 

9 Risk and Complications

There are several risks and complications associated with Autoimmune hepatitis.

Untreated autoimmune hepatitis leads to liver cirrhosis.

This may also result in

  • enlargement of veins in the esophagus,
  • accumulation of fluid in the abdomen,
  • liver failure and even liver cancer